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General NPI Number Information
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NPI Number | 1386634608
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Entity Type | Organization
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Legal Business Name | SIGNATURE HEALTH SERVICES, LLC
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Dates
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Enumeration Date | 10/27/2005
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Last Update Date | 08/13/2010
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Provider Practice Location Address
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Address Line | 540 OFFICENTER PL SUITE 295
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City | GAHANNA
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State | OH
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Zip | 43230-5317
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Country | US
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Telephone | 614-501-1879
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Fax | 614-501-2934
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Provider Business Mailing Address
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Address Line | 540 OFFICENTER PL SUITE 295
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City | GAHANNA
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State | OH
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Zip | 43230-5317
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Country | US
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Telephone | 614-501-1879
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Fax | 614-501-2934
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Authorized Official
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Title or Position | COO
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Name | JACK GOLDSBERRY
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Credential |
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Telephone | 330-666-3810
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 368015
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License Number State | OH
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